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Prevalence and Clinical Correlates of Insomnia in Depressive Disorders: The CRESCEND Study

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Author(s)
Seon-Cheol ParkJae-Min KimTae-Youn JunMin-Soo LeeJung-Bum KimSeung-Hee JeongYong Chon Park
Keimyung Author(s)
Kim, Jung Bum
Department
Dept. of Psychiatry (정신건강의학)
Journal Title
Psychiatry investigation
Issued Date
2013
Volume
10
Issue
4
Keyword
InsomniaDepressive disordersAnxiety symptomsGastrointestinal somatic symptomsGlobal severity
Abstract
OBJECTIVE:

To investigate the prevalence, clinical manifestations, and clinical correlates of insomnia in a large cohort of Korean patients with depressive disorders.

METHODS:

We recruited 944 patients with depressive disorders from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Psychometric scales were used to assess depression (HAMD), anxiety (HAMA), psychotic symptoms (BPRS), global severity (CGI-S), and functioning (SOFAS). Insomnia levels were determined by adding the scores for all items on the HAMD insomnia subscale. The clinical characteristics of the patients with 'low insomnia' (summed score ≤3 on the HAMD subscale) and 'high insomnia' (score ≥4) were compared using statistical analyses. A logistic regression model was constructed to identify factors associated with 'high insomnia' status.

RESULTS:

Symptoms of insomnia were present in 93% of patients, while simultaneous early, middle, and late insomnia affected 64.1%. The high insomnia patients were characterized by significantly greater age, higher symptom levels (including core, gastrointestinal somatic and anxiety symptoms, and suicidal ideation), higher global severity and incidence of physical disorders, and greater insight. Explanatory factors of 'high insomnia' status were older age, higher gastrointestinal somatic and anxiety symptom levels, higher global severity, and greater insight.

CONCLUSION:

In clinical psychiatry, insomnia has been significantly underdiagnosed and undertreated. It affects most patients with depressive disorders, and is indicative of the global severity of depression. Active efforts to diagnose and treat insomnia in patients with depressive disorders should be strongly encouraged. Further research is needed to improve the diagnosis and treatment of insomnia in depressive patients.


KEYWORDS:

Anxiety symptoms; Depressive disorders; Gastrointestinal somatic symptoms; Global severity; Insomnia
Keimyung Author(s)(Kor)
김정범
Publisher
School of Medicine
Citation
Seon-Cheol Park et al. (2013). Prevalence and Clinical Correlates of Insomnia in Depressive Disorders: The CRESCEND Study. Psychiatry investigation, 10(4), 373–381. doi: 10.4306/pi.2013.10.4.373
Type
Article
ISSN
1738-3684
DOI
10.4306/pi.2013.10.4.373
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33597
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Psychiatry (정신건강의학)
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